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NURS2006: Mrs Wendy Kingston Case Study - Chronic Obstructive Pulmonary Disease - Nursing Assessment Answer
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Internal Code: 1AFGID
Code: NURS2006
Mrs. Kingston Case Study Assessment Answer
Assignment Task: NURS2006 Mrs Wendy Kingston Case Study Mrs Kingston is a widow. Her husband Mr Joe Kingston passed away last year. They had been married for 50 years. They own a vegetable farm in Liverpool. They have two daughters. She has a good relationship with her daughters. Both of her children are married, and they live in Hornsby and Kensington. NURS2006 Occupation and Socio-economic status: Mrs Kingston has lived in Liverpool for 35 years. She has a vegetable farm in Liverpool. The farm belongs to her father; he passed it to her before he passed away. The vegetable farm is her life. Before Mr Kingston passed away, Mr and Mrs Kingston worked together on their vegetable farm every day over the past 34 years. They sold the products to the local restaurants. Although they did not earn much money, it was sufficient for their living standard. Mrs Kingston tries to keep her business. Since she suffers from COPD, she is still able to help with housework and cooking. However, she can only work on her farm occasionally. Her younger daughter Lorraine and grandson Jason come over on weekends to help her out. However, since she suffers from COPD, she is on oxygen 17 hours a day. She needs to hire oxygen every month, and the power bill is astronomical. She even has to spend a few thousand dollars on portable oxygen as she cannot go out without it. NURS2006 Living Arrangements and Social network: Mrs Kingston has lived in Liverpool since she was young. She is active in the local Catholic church. She used to sing in the choir and taught knitting to the local ladies. She loves music and sometimes plays the violin at social gatherings. However, her breathing affects her singing and violin performance. She is embarrassed when she has to sing; she often experiences shortness of breath and gasps for air, so she needs to stop. Her hands sometimes are shaky. She has gradually withdrawn from social activities since last year. NURS2006 Emotional State of Mind: Mrs Kingston is not coping well with her condition. She is on 2 litres of oxygen via nasal prongs during the night, but by just walking to the bathroom can cause her oxygen saturation to drop from 94 to 81%. So she needs to sit down on the bed and wait until the oxygen builds up to a satisfactory level, then she can go back to sleep. She has never felt so sad in her life. She describes that a once confident person has changed, disappeared or completely gone. She has a 30-cigarette a day smoking history previously. She has tried to quit smoking since she was diagnosed with COPD. However, she occasionally smokes especially when she feels stressed. She gets upset when she becomes breathless, especially when she recalls what her husband said in the past, “My darling, I am here to make sure that you do not do anything that is not good for you”. However, she has no idea who can help her situation now. NURS2006 Current treatment and management: Mrs Kingston was admitted to your ward a few days ago due to acute exacerbation of COPD. She also has a history of hypertension and heart failure following myocardial infarction at age 68 years. Physical examination showed: NURS2006- Vital signs: blood pressure 138/74 mmHg, pulse 78 bpm, respiration 32 rpm.
- Mental status: alert and oriented.
- Unable to speak in full sentences, audible wheezing, pulse oximetry 86%
- Lisinopril 20mg twice daily PO
- Metoprolol 50 mg twice daily PO
- Spironolactone 25mg daily PO
- Frusemide 40 mg daily PO
- Salmeterol/fluticasone 50/500 dry powdered inhaler (DPI) 2 puff inhaled twice daily
- Tiotropium DPI one cap inhaled daily
- Salbutamol 100 mcg and Ipratropium bromide metered dose inhaler (MDI) 2 puffs every 6 hours as needed
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